compassion training for health, mental health and care
TRANSCRIPT
Compassion training for health, mental health and care workers to boost wellbeing and prevent burnout
Workshop for Tuesdays with Nexus –21st September 2021.
Dr Debbie Ling, Department of Social Work, Monash [email protected]
1
Compassion Definition = concerned response to another’ssuffering combined with a desire to alleviate that suffering
Compassion is widely acknowledged as a virtue across cultures.
Compassion is considered to be innate, evolutionary benefit.
Compassion is the foundation of healthcare and functioning societies.
Compassion is different to empathy, pity and sympathy
Compassion = concerned response to another’s suffering and wish to alleviate that suffering
Empathy = resonance with how another is feeling, can be cognitive or affective (feeling)
Pity = feel sorry for another but with an aspect of looking down upon them
Sympathy = feeling sorry for another but lacks the aspect of wishing to alleviate their suffering
“The Social Brain Hypothesis”
Dunbar, R. I. (1998). The social brain hypothesis. Evolutionary Anthropology: Issues, News, and Reviews: Issues, News, and Reviews, 6(5), 178-190.
Humans are social animals.
Caring, compassion, cooperation are fundamental to survival.
We’re wired to connect.
Important research on social relationships
1. A positive state of mind, leads to feelings of warmth, concern, reward and affiliation (Klimecki et al. 2013; Preckel et al. 2018)
2. Compassion can be trained (Leiberg et al. 2011, Weng et al. 2013)
3. Compassion leads to a range of prosocial outcomes including increased caring behaviors, social connectedness, altruism (Hofmann et al. 2011; Mayseless 2011; Preston 2013)
4. Compassion improves healthcare worker well-being (Fredrickson et al. 2013; Klimecki et al. 2013)
Compassion research in the last 2 decades
5. Compassion leads to less stress in the caregiver (Dahl, Lutz & Davidson 2015)
6. Compassion has a positive impact on those who witness and receive it (Kanov et al. 2004)
7. Compassion reduces the desire to punish the other (Condon & De Steno 2011)
8. Compassion and empathy use different neural pathways (Klimecki et al. 2013)
Compassion research cont’d
“Compassion fatigue” is now considered an outdated incorrect term.
It is actually “empathic distress fatigue”.
Empathic distress fatigue, not compassion fatigue
Emotional contagion
In emotional contagion, there is a lack of differentiation between yourself and the other.
In empathy, you may feel with someone but you are aware that it’s not your suffering.
In compassion, you wish for the other’s suffering to be relieved, you are not suffering yourself.
Distinction between self and other is crucial.
•Need to train compassion to change the behavioural sequence. This can be counter-intuitive as another’s suffering can be challenging. Understandable we don’t always get to compassion for a variety of reasons.
•Notice the “reward” when you can go into compassion instead of distress or avoidance. “Helper’s High” kicks in.
•Level of burnout in palliative care workers not higher than in other areas. The importance of realistic viewpoints re: work that is being done. World view is important.
•Helpful to understand the compassion process so healthcare workers are then motivated to practice compassion.
Compassion
The Compassion Process
YES
YES
Empathic distress Exit (Self-focus)
YES Empathic concern (Other-focus) Continue “Just like me, this
person wishes to be YES happy and not to
suffer”
YES
Do I notice the
other?
Is the other
suffering?
Do I empathise with them?
Do I recognise common
humanity?No one
wants to suffer
I wish for their suffering to be alleviated
COMPASSION
Can you think of an instance where you went into either compassion or empathic distress in response to another person’s suffering?
Pause and reflect
Compassion summary
Those in the helping professions are regularly exposed to the suffering of others, be careful about emotional contagion. Self-awareness needed.
Workers in the helping professions are trained to care for others, but who is caring for the carer?
Workers in the caring/helping professions often put a lot of energy into giving out to others.
Taking the time to step back and check where you are at.
Finding the balance. Self-care is crucial. Making it a priority. Boundaries.
Systems pressures, worker burnout and self-care
Systems pressures, lack of resources, frustrations with limitations are all a part of working life.
Being realistic about what you can and can’t do.
Understanding the importance of what you do. The small things count.
Reflection: Finding ways to work within the limitations and still feel you are making a difference.
Systems pressures, worker burnout and self-care cont’d
Annie Lennox and Dave Stewart – “Remember those who helped you along the way”
Eurythmics – British pop duo 1980’s
1. Recall being on the receiving end of help/support from others
Take a moment to think of all the people who have ever helped, supported or had a positive influence on you in any way whatsoever (not just key caregivers). It can even be quite a fleeting interchange.
2. Recall a time when you have benefitted someone elseThink of a time when you did something (no matter how small) which benefitted someone else.
Reflection points
Share on some of the below themes:
“A memorable experience at work”
“Sometimes it’s all worthwhile”
“A moment of connection”
“ I felt humbled by…”
“ A person I’ll always remember”
Tip: create a library of positive and/or meaningful work memories you can dip into or re-visit
Gottman Principle: Five positives to offset a negative
Compassion and connection to others can be easily disrupted
Multiple demands on our attention. Darley and Batson (1973) Good Samaritan Study demonstrated that self absorption and being in a hurry inhibits tuning into others.
Situational factors are important, emotions are relational, context specific.
Important to be mindful, be able to self-regulate.
Need both self-awareness and social awareness.
Modern life means people have less time to get to know others, easy to jump to conclusions or make incorrect assumptions about someone else.
Equally, not uncommon for strangers to help each other. Pain is a powerful connector e.g. if an elderly person trips over in the supermarket, other shoppers usually step in to help.
COVID has heightened common humanity
Anyone can get sick at any time, including healthcare workers.
Everyone is someone’s mother, father, son, daughter.
Common humanity is the most inclusive prosocial perspective to hold – all people become the in-group.
It’s a “we” instead of an “us” versus “them”.
TV2 Danmark (2017) TV 2/All that we share https://www.youtube.com/watch?v=jD8tjhVO1Tc
TV2 Danmark (2019) TV2/All that we share – connectedhttps://www.youtube.com/watch?v=UQ15cqP-K80
Common humanity - tips to heighten it
Every person has a story and a background.
Chance can play a major part in how someone’s life plays out. (Reflect on where chance has favoured you positively or impacted you negatively)
Seeing the child in the grown up.
Recognition of people’s potential for positive change.
The truth of impermanence and change.
Common humanity training content
Education around humans are a social species, evolutionary benefit to cooperation, many animal species cooperate e.g. bees, ants, dolphins, elephants
Humans are born hardwired to connect to others – necessary for survival
Functioning societies require collaboration and working together towards mutual goals
Common humanity training content cont’d
Golden Rule “Treat others as you would like to be treated” – embedded across cultures and throughout history for several thousand years.
Use of logic and reasoning to guide how we view others & help overcome superficial stereotypes. Easy to categorise people, takes conscious effort to see the bigger picture.
Emphasising similarities (e.g. “everyone wishes to be happy & healthy”) instead of differences. Even if people have different viewpoints, they still have the same needs.
Respecting the person’s fundamental humanity does not mean one condones negative actions. People are still held accountable for their actions. Aiming to try to fix problems, but take hatred out of the equation.
“All unskillful behaviour is the tragic expression of an unmet need” – Marshall Rosenberg, founder of Non Violent Communication.
When people behave in challenging ways, it’s usually because they are afraid of something or worried/anxious.
Recognising the source of others’ difficult behaviours
US inmates who saved guard’s life to have sentences cut (2017, June 21) BBC Newshttps://www.bbc.com/news/world-us-canada-40350048
“If you want others to be happy, practice compassion.
If you want to be happy, practice compassion” – Dalai Lama
“Compassion is the basis of all morality” – Arthur Schopenhauer
“Simplicity, patience, compassion. These three are your greatest treasures” – Lao Tzu
“The purpose of human life is to serve, and to show compassion and the will to help others” – Albert Schweitzer
Compassion Quotes
Schwartz Center for Compassionate Healthcare (free webinars and information on Schwartz Rounds)
https://www.theschwartzcenter.org/programs/compassion-in-action-webinars/
Compassion Institute (runs online training courses)
https://www.compassioninstitute.com/
Monash Centre for Consciousness and Contemplative Studies (from early 2022 – will launch online compassion course):
https://www.monash.edu/arts/consciousness-contemplative-studies
Providers of Compassion Cultivation Training courses in Australia:
Dr Petrina Barson
https://petrinabarson.net/
Kim Koop
https://www.kimkoop.com.au/
Resources
Charter for Compassion Australia (find out about other compassion activities around Australia)
https://www.charterforcompassion.com.au/
Stanford Center for Compassion and Altruism Research and Education
http://ccare.stanford.edu/
Emory Center for Contemplative Science and Compassion-Based Ethics (runs Cognitively Based Compassion Training Course)
https://compassion.emory.edu/
Center for Healthy Minds, University of Wisconsin-Madison
https://centerhealthyminds.org/
Resources and Compassion Training cont’d
Ashar, Y.K., Andrews-Hanna, J.R., Dimidjian, S. and Wager, T.D. (2017). Empathic care and distress: predictive brain markers and dissociable brain systems. Neuron, 94(6), pp.1263-1273.
Batson, C. D., Eklund, J. H., Chermok, V. L., Hoyt, J. L., & Ortiz, B. G. (2007). An additional antecedent of empathic concern: valuing the welfare of the person in need. Journal of personality and social psychology, 93(1), 65.
Blum, L. (1980). Compassion. In A. O. Rorty, (Ed.), Explaining emotions (pp.507-571). University of California Press.
Cassell, E. J. (2009). Compassion. In C. R. Snyder & S. J. Lopez (Eds.), Oxford handbook of positive psychology (pp. 393-404). Oxford University Press.
Condon, P., & DeSteno, D. (2011). Compassion for one reduces punishment for another. Journal of Experimental Social Psychology, 47(3), 698-701.
Dahl, C. J., Lutz, A., & Davidson, R. J. (2015). Reconstructing and deconstructing the self: cognitive mechanisms in meditation practice. Trends in cognitive sciences, 19(9), 515-523.
Darley, J. M., & Batson, C. D. (1973). " From Jerusalem to Jericho": A study of situational and dispositional variables in helping behavior. Journal of personality and social psychology, 27(1), 100.
Feldman, C., & Kuyken, W. (2011). Compassion in the landscape of suffering. Contemporary Buddhism, 12(01), 143-155.
Fredrickson, B. L., Cohn, M. A., Coffey, K. A., Pek, J., & Finkel, S. M. (2008). Open hearts build lives: positive emotions, induced through loving-kindness meditation, build consequential personal resources. Journal of personality and social psychology, 95(5), 1045.
Hofmann, S. G., Grossman, P., & Hinton, D. E. (2011). Loving-kindness and compassion meditation: Potential for psychological interventions. Clinical psychology review, 31(7), 1126-1132.
Jinpa, T. (2016). A fearless heart: How the courage to be compassionate can transform our lives. Avery.
Kanov, J. M., Maitlis, S., Worline, M. C., Dutton, J. E., Frost, P. J., & Lilius, J. M. (2004). Compassion in organizational life. American Behavioral Scientist, 47(6), 808-827.
Klimecki, O.M., Leiberg, S., Lamm, C. and Singer, T. (2012). Functional neural plasticity and associated changes in positive affect after compassion training. Cerebral cortex, 23(7), pp.1552-1561.
Klimecki, O.M., Leiberg, S., Ricard, M. and Singer, T. (2013). Differential pattern of functional brain plasticity after compassion and empathy training. Social cognitive and affective neuroscience, 9(6), pp.873-879.
References
Leiberg, S., Klimecki, O., & Singer, T. (2011). Short-term compassion training increases prosocial behavior in a newly developed prosocial game. PloS one, 6(3), e17798.
Ling, D., Olver, J., & Petrakis, M. (2018). Outcomes from a Compassion Training Intervention for Health Care Workers. Czech & Slovak Social Work/Sociální Práce/SociálnaPráca, 18(4).
Mayseless, O. (2016). Caring and meaning in psychotherapy. In Clinical Perspectives on Meaning (pp. 363-381). Springer, Cham.
Monroe, K. R. (1998). The heart of altruism: Perceptions of a common humanity. Princeton University Press.
Nussbaum, M. (1996). Compassion: The basic social emotion. Social Philosophy and Policy, 13(1), 27-58.
Preckel, K., Kanske, P., & Singer, T. (2018). On the interaction of social affect and cognition: empathy, compassion and theory of mind. Current Opinion in Behavioral Sciences, 19, 1-6.
Preston, S. D. (2013). The origins of altruism in offspring care. Psychological bulletin, 139(6), 1305.
Ricard, M. (2015). Altruism: the power of compassion to change yourself and the world. Atlantic Books Ltd.
Strauss, C., Taylor, B. L., Gu, J., Kuyken, W., Baer, R., Jones, F., & Cavanagh, K. (2016). What is compassion and how can we measure it? A review of definitions and measures. Clinical psychology review, 47, 15-27.
Van Der Cingel, M. (2009). Compassion and professional care: exploring the domain. Nursing Philosophy, 10(2), 124-136.
Von Dietze, E., & Orb, A. (2000). Compassionate care: a moral dimension of nursing. Nursing Inquiry, 7(3), 166-174.
Weng, H.Y., Fox, A.S., Shackman, A.J., Stodola, D.E., Caldwell, J.Z., Olson, M.C., Rogers, G.M. and Davidson, R.J., (2013). Compassion training alters altruism and neural responses to suffering. Psychological science, 24(7), pp.1171-1180.
References cont’d
